This version was machine-translated from German and has not been medically reviewed. The authoritative version is the German version.

Celiac disease: diagnosis without biopsy in children and adolescents

Checks whether, according to the S2k guideline 2021 and ESPGHAN 2020, a diagnosis of celiac disease without biopsy is possible: tTG-IgA from 10 times the cutoff, EMA-IgA in a second blood sample, counseling; with IgA deficiency always biopsy

Child

Age

The child ate gluten-containing food at the time of blood sampling (no gluten-free or strongly gluten-reduced diet)

Laboratory

Total IgA in serum

tTG-IgA, measured value (laboratory unit)

tTG-IgA, laboratory cutoff (upper limit of normal) (laboratory unit)

Same unit as the measured value, taken from the report of the test used.

IgG test (tTG-IgG, EMA-IgG or DGP-IgG)

Decision

Counseling by pediatric gastroenterology

EMA-IgA in a second blood sample

Calculation aid for healthcare professionals: the calculator reproduces what the sources cited assign to the inputs. Clinical assessment and every treatment decision remain with the treating physician. Inputs and results are not stored.

Frequently asked questions

Celiac disease: diagnosis without biopsy in children and adolescents: What does this calculator compute?

Decision aid according to the S2k guideline on celiac disease (DGVS, December 2021, recommendations 2.10 and 2.16) and the ESPGHAN guidelines 2020: in children and adolescents under 18 years with tTG-IgA equal to or above 10 times the laboratory’s cutoff, after counseling by pediatric gastroenterologists a diagnosis without biopsy is possible if EMA-IgA is positive in a second blood sample. Below 10 times the cutoff, when the family has doubts and in IgA deficiency, biopsies are needed. The calculator computes the factor from the measured value and the cutoff of the test used.

Celiac disease: diagnosis without biopsy in children and adolescents: Which sources is this calculator based on?

Felber J, Bläker H, Fischbach W, Koletzko S, Laaß MW, Lachmann N, Lorenz P, Lynen P, Reese I, Scherf K, Schuppan D, Schumann M: Updated S2k guideline on celiac disease of the German Society of Gastroenterology, Digestive and Metabolic Diseases (DGVS), AWMF register 021-021, December 2021 (Z Gastroenterol 2022;60:790–856, doi 10.1055/a-1741-5946); valid until 31 October 2026 (2021); Husby S, Koletzko S, Korponay-Szabó I, Kurppa K, Mearin ML, Ribes-Koninckx C, Shamir R, Troncone R et al.: European Society Paediatric Gastroenterology, Hepatology and Nutrition Guidelines for Diagnosing Coeliac Disease 2020 (J Pediatr Gastroenterol Nutr 2020;70:141–156) (2020)